| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $62K | $17K | $78K | 25.35% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | THE GUARDIAN LIFE INSURANCE CO. OF AMERICA | $56K | — | $56K | 23.27% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $33K | $12K | $45K | 20.71% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 5.95% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $6K | $21K | 20.84% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $4K | $15K | 20.81% |
| CHAMPION BENEFITS3 Filed as: CHAMPION BENEFITS APPROACH INC | 1455 LINCOLN PARKWAY E SUITE 100 ATLANTA, GA 303462215 | AMERITAS LIFE INSURANCE CORP. | $7K | $0 | $7K | 10.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP. | 1,509 | $71K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,157 | $218K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $74K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 658 | $530K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,509 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.